Annals of Allergy Asthma & Immunology最新文献

{"title":"Comparative Effectiveness of Fixed-Dose ICS/LABA Therapy in Adult Patients with Asthma.","authors":"Te-Jung Kung, Ching-Fu Weng, Shan-Chieh Wu, Fang-Ju Lin","doi":"10.1016/j.anai.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.019","url":null,"abstract":"<p><strong>Background: </strong>Inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) therapy is a mainstay of asthma management, yet real-world comparative evidence across different formulations remains limited.</p><p><strong>Objective: </strong>This study aimed to compare the effectiveness of prescribed fixed-dose ICS/LABA combinations in reducing moderate-to-severe asthma exacerbations (MSAEs) among adults, stratified by initial ICS dose.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from Taiwan's National Health Insurance Research Database and Cause of Death Registry (2016-2021). Adults with asthma who initiated fixed-dose ICS/LABA therapy between 2017 and 2020 were included. Treatment groups comprised budesonide/formoterol (reference), extrafine beclometasone dipropionate/formoterol, fluticasone propionate/salmeterol, and fluticasone furoate/vilanterol. Patients were stratified by initial ICS dosage into low-dose and medium-to-high-dose cohorts. Risk of MSAE was assessed using Cox proportional hazards model with inverse probability of treatment weighting for covariate adjustment.</p><p><strong>Results: </strong>Among 128,426 eligible patients, 35,532 were in the low-dose and 88,954 in the medium-to-high-dose cohort. In the low-dose cohort, extrafine beclometasone dipropionate/formoterol (HR: 0.97, 95% confidence interval [CI]: 0.88-1.09) and fluticasone propionate/salmeterol (HR: 1.16, 95% CI: 0.98-1.37) had a similar risk of MSAE compared to budesonide/formoterol. In the medium-to-high-dose cohort, fluticasone furoate/vilanterol was associated with a slightly lower MSAE risk compared to budesonide/formoterol (HR: 0.92, 95% CI: 0.86-0.97), particularly in those with prior exacerbations (HR: 0.84, 95% CI: 0.77-0.91). Extrafine beclometasone dipropionate/formoterol (HR: 0.96, 95% CI: 0.89-1.04) and fluticasone propionate/salmeterol (HR: 1.06, 95% CI: 0.98-1.15) showed no significant difference.</p><p><strong>Conclusion: </strong>The findings suggest that fluticasone furoate/vilanterol may offer a potential advantage for asthma management compared to other fixed-dose ICS/LABA combinations.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between body weight, asthma burden, and T2 inflammation among under-resourced children.","authors":"David Thompson, Cynthia M Visness, Robert A Wood, George T O'Connor, Rachel G Robison, Gurjit K Khurana Hershey, Carolyn M Kercsmar, Jeffrey Chambliss, Andrew H Liu, Christine Johnson, Stephanie Lovinsky-Desir, Leonard B Bacharier, James E Gern, Daniel J Jackson, William W Busse, Peter J Gergen, Stephen J Teach, Deepa Rastogi","doi":"10.1016/j.anai.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.018","url":null,"abstract":"<p><strong>Background: </strong>Overweight/obesity is a risk factor for asthma, particularly in under-resourced children, and contributes to higher disease burden. T2 inflammation, a key characteristic of asthma endotypes, has been inconsistently associated with burden of obesity-related asthma, which may be due to limited overlap between different T2 features, including elevated total serum IgE, eosinophilia, and allergen sensitization.</p><p><strong>Objective: </strong>To investigate the effects of different T2 features on association of overweight/obesity with asthma burden in under-resourced children.</p><p><strong>Methods: </strong>Among 2,160 children ages 6-20 years from four Inner-City Asthma Consortium cohorts, we investigated the association of overweight/obesity with asthma burden (unscheduled visits, hospitalizations, exacerbations, asthma control, and pulmonary function), and the effect of T2 features (total IgE higher than age-specific cutoffs, total eosinophils >300 cells/ul, or sensitization to ≥2 allergens) on the association.</p><p><strong>Results: </strong>The odds (OR (95% CI)) of unscheduled visits was higher among those with overweight/obesity (1.35 (1.04-1.75)) and allergen sensitization (1.35 (1.02-1.80)), hospitalizations was higher among those with elevated total IgE (2.17 (1.27-3.69)) and eosinophilia (2.80 (1.56-5.21)), and poor asthma control was higher among those with elevated total IgE (1.27 (1.09-1.41)). Overweight/obesity and all T2 features were associated with lower FEV1/FVC ratio. There was no synergistic or clinically significant mediating influence of any of T2 features on the association of overweight/obesity with asthma burden.</p><p><strong>Conclusion: </strong>Among under-resourced children with asthma, overweight/obesity and T2 inflammation are largely independently associated with unscheduled visits and pulmonary function deficits. T2 inflammation, but not overweight/obesity, is associated with poor control and hospitalizations.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why an Allergist Should See Another Allergist.","authors":"Lisa M Bartnikas, Mitchell R Lester, Theresa A Bingemann","doi":"10.1016/j.anai.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.020","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Aspirin Therapy after Desensitization (ATAD) Tolerance in Aspirin-Exacerbated Respiratory Disease (AERD) Patients.","authors":"Lancelot P Herpin, Alexa M Finuoli, Alan D Workman, Si Hao Tang, Krithika Kuppusamy, Michael A Kohanski, James N Palmer, Nithin D Adappa, Jennifer E Douglas, John V Bosso","doi":"10.1016/j.anai.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.021","url":null,"abstract":"<p><strong>Background: </strong>For over 40 years, aspirin desensitization (AD) with aspirin therapy after desensitization (ATAD) has been a recognized treatment for Aspirin-Exacerbated Respiratory Disease (AERD). This study aimed to characterize the rate of ATAD-associated complications leading to discontinuation and identify associated risk factors.</p><p><strong>Objective: </strong>To evaluate the rate and causes of ATAD intolerance and identify demographic factors that may predict intolerance in AERD patients.</p><p><strong>Methods: </strong>360 AERD patients who underwent AD and ATAD at a tertiary center from August 2016 to April 2024 were reviewed. A joint model combining linear mixed and Cox proportional hazards models was used to assess associations between demographic factors, aspirin dosage, and ATAD intolerance.</p><p><strong>Results: </strong>Of 278 patients included, four (1.4%) failed desensitization, and 44 (15.8%) discontinued ATAD. 10 patients (3.6%) experienced major complications requiring ED visit or hospitalization. Common discontinuation causes included gastrointestinal symptoms, anaphylaxis, cutaneous reactions, and airway symptom exacerbation. On average, aspirin dosage decreased overtime (-10 mg daily per month; p < 0.0001) and was lower in older patients (-7.78 mg daily; p < 0.0001), reflecting current dosage practices. Peri-/post-menopausal female status was associated with reduced ATAD intolerance risk (HR = 0.4; p = 0.041), while pre-menopausal status showed a non-significant increase (HR = 2.28; p = 0.087). ATAD intolerance was more likely in Hispanic/Latino (HR = 8.2; p = 0.0013) and African American patients (HR = 4.03; p = 0.0015), and increased modestly with age (HR = 1.08; p < 0.0001). Longitudinal aspirin dosage was not associated with overall intolerance or intolerance due to gastrointestinal complications specifically after adjustment.</p><p><strong>Conclusion: </strong>ATAD tolerance was lower in Hispanic/Latino, African American, and older patients, higher in peri-/post-menopausal females, and not associated with longitudinal aspirin dosage.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Access to Life-Saving Medication in Allergy-Immunology: The Predicate Device - Past, Present, and Future.","authors":"Marcus Shaker, Matthew R Shaker, Marylee Verdi","doi":"10.1016/j.anai.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.017","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Breast to Bite: Nutritional Management in Infantile FPIES.","authors":"Lydia Su Yin Wong, Brianne L Schmidt, Kirsi M Järvinen, Marion Groetch","doi":"10.1016/j.anai.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.005","url":null,"abstract":"<p><p>Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy that presents primarily in infancy. Managing nutrition in infants with FPIES presents unique challenges due to its lack of diagnostic biomarkers, and the high potential for feeding difficulties, restricted diets, and growth faltering. Breastfed infants may occasionally react to trace food proteins in human milk, requiring maternal elimination diets and cautious reintroduction strategies. Formula-fed infants with cow's milk or soy triggered FPIES may need extensively hydrolyzed or amino acid-based formulas. Introduction of complementary foods requires a careful, stepwise approach informed by each child's specific food triggers. In addition to increased risk for Ig-E mediated food allergy, delayed introduction of higher-risk foods may compound nutritional risk, particularly for energy, protein, iron, zinc, and other nutrients. Feeding difficulties, food aversion, and caregiver anxiety can further affect growth and quality of life for both infant and family. Regular growth monitoring, caregiver education, and involvement of a multidisciplinary team including a dietitian experienced in food allergy are essential to optimize outcomes. Three illustrative cases highlight practical management strategies from management of an exclusively breastfed infant with FPIES to reintroduction of previously avoided foods. A proactive, individualized nutritional approach is vital to supporting healthy growth and quality of life in this vulnerable population.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenge Testing and Quality of Life in Adults with Suspected Drug or Food Allergies.","authors":"Lujain Majdi Qutub, Genevieve Bouvette, Florian Stehlin, Connor Prosty, Ghislaine Annie Clarisse Isabwe","doi":"10.1016/j.anai.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.010","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of food protein-induced enterocolitis syndrome (FPIES): Global trends, emerging triggers, and natural history.","authors":"Sara Anvari, Malika Gupta, Rory Nicolaides, Hideaki Morita, Leena Han, Julia Upton, Pooja Varshney, Melanie Ruffner, Mary Grace Baker","doi":"10.1016/j.anai.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.006","url":null,"abstract":"<p><p>Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by delayed gastrointestinal symptoms. It is thought that immune and neuroimmune mechanisms drive FPIES pathophysiology, but this remains incompletely understood. There are no specific biomarkers to confirm the FPIES diagnosis, monitor for resolution, or assess reactivity to additional food triggers. FPIES is thought to occur globally, with most literature from industrialized countries. While the initial reports of FPIES involved infants and toddlers, it is now apparent that the diagnosis can present into adulthood. For children, the major FPIES triggers vary geographically. Cow's milk is a major trigger globally, and other notable triggers including grains in the US and Australia, fish in Europe, and hen's egg in Japan. In the last decade, there has been a surge in pediatric cases of FPIES to hen's egg in the US and Japan and peanut in the US. This rise coincides with implementation of early introduction guidelines that encourage feeding these foods in early infancy. It is hypothesized that there may be a window of FPIES susceptibility in infancy, with trends in FPIES triggers mirroring feeding practices during this period. For adults, seafood is the most common trigger food. Further research into FPIES pathophysiology is needed, as enhanced understanding of the underlying mechanisms, identification of specific biomarkers, and recognition of risk factors for FPIES may guide predictions of future trends and best practices for dietary management.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AIRWAY OVERLAP SYNDROMES WITH ASTHMA.","authors":"Carlos Amado, Daniel Lopez-Padilla, Raúl Méndez, Miguel Angel Martinez-Garcia","doi":"10.1016/j.anai.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.012","url":null,"abstract":"<p><p>The airways, defined as the segment of the respiratory system extending from the pharynx to the alveoli, represent a crucial site for various inflammatory airway diseases. Among the most common are asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, and obstructive sleep apnea (OSA). Due to their high individual prevalence, it is not unusual for a single patient to suffer from two or more of these conditions simultaneously. Beyond this epidemiological coincidence, several pathophysiological links, despite notable differences among the diseases, have been identified. These connections influence not only the mutual prevalence of the disorders but also their clinical management and prognosis, frequently in a bidirectional manner. This constellation of interactions has been termed \"overlap syndromes.\" Overlap syndromes involving asthma are especially frequent, including asthma-COPD overlap syndrome (ACOS), asthma-OSA overlap syndrome, and asthma-bronchiectasis overlap syndrome (ABOS). These syndromes often exhibit bidirectional relationships. Asthma, for instance, may aggravate COPD symptoms, prompting modifications in its treatment; it may also worsen preexisting OSA through increased pharynx collapsability, the use of inhaled corticosteroids or contribute to more frequent bronchiectasis exacerbations. Conversely, the presence of COPD can hinder adequate asthma control, bronchiectasis may enhance the inflammatory burden and exacerbate asthma, and OSA can induce harmful nocturnal oxygen desaturations that impair asthma outcomes. These complex and dynamic interactions underscore the importance of recognizing overlap syndromes in clinical practice. An integrated, individualized approach that considers the coexistence of multiple airway diseases is essential for optimizing diagnosis, therapeutic interventions, and long-term prognosis in affected patients.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic advances in FPIES pathophysiology.","authors":"George N Konstantinou, Lydia Su Yin Wong","doi":"10.1016/j.anai.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.007","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}